目的 研究延长手术时间是否会对局部晚期食管癌新辅助放化疗后经组织学证实有残留病灶的患者的生存率、病理结果或术后并发症产生负面影响。历史上，标准手术时间 (TTS) 为完成后六至八周nCRT 的。延长 TTS 的影响越来越受到人们的关注，但其对生存率和手术发病率的结果却相互矛盾。可以假设，在 nCRT 完成六周后有残留病灶的患者中，延长 TTS 可能与较差的生存率和较高的发病率相关。 nCRT 后六周活检证实有残留病灶并接受手术的局部晚期食管癌患者，根据手术间隔进行分类（TTS>12w vs. TTS≤12w）。这项研究的主要结果是总体生存率。次要结局是无病生存率、手术结果、病理结果和术后并发症。多变量 Cox 回归用于比较其他结果的生存率和逻辑回归，并根据混杂因素年龄、cT、cN、Charlson 合并症指数、nCRT 期间的体重减轻以及 nCRT 完成后的 WHO 表现评分进行调整。 TTS> 纳入了 40 名患者TTS≤12w 为 12w 和 127。 TTS>12w与更好的总生存期（调整后风险比（aHR）0.46，95%CI 0.24-0.90）和无病生存期（aHR 0.48，95%CI 0.24-0.94）相关，但也与更多术后呼吸道并发症相关（aOR 3.66，95%CI 1.52-9.59）。两组之间的其他结果相当。食管癌 nCRT 完成后，经组织学证明残留疾病的患者延长 TTS 不会对总体生存率和无病生存率产生负面影响，但患者术后呼吸系统并发症的风险确实较高。版权所有 © 2024 作者。由 Wolters Kluwer Health, Inc. 出版

To investigate whether prolonged time to surgery negatively affects survival, pathological outcome or postoperative complications in patients with histologically proven residual disease after neoadjuvant chemoradiotherapy for locally advanced esophageal cancer.Historically, the standard time to surgery (TTS) has been six to eight weeks after completion of nCRT. The effect of prolonged TTS is gaining interest, with contradicting results on survival and surgical morbidity. It can be hypothesized that, in patients with residual disease six weeks after completion of nCRT, prolonged TTS might be associated with worse survival and higher morbidity.Patients with locally advanced esophageal cancer who had biopsy-proven residual disease six weeks after nCRT and underwent surgery, were categorized according to interval to surgery (TTS>12w vs. TTS≤12w). Primary outcome of this study was overall survival. Secondary outcomes were disease-free survival, surgical outcomes, pathological outcomes, and postoperative complications. Multivariable Cox regression was used for comparing survival and logistic regression for other outcomes, adjusted for the confounders age, cT, cN, Charlson comorbidity index, weight loss during nCRT, and WHO performance score after completion of nCRT.Forty patients were included for TTS>12w and 127 for TTS≤12w. TTS>12w was associated with better overall survival (adjusted hazard ratio (aHR) 0.46, 95%CI 0.24-0.90), and disease-free survival (aHR 0.48, 95%CI 0.24-0.94), but also with more postoperative respiratory complications (aOR 3.66, 95%CI 1.52-9.59). Other outcomes were comparable between both groups.Prolonged TTS in patients with histologically proven residual disease after completion of nCRT for esophageal cancer did not have a negative effect on overall and disease-free survival, but patients did have a higher risk for postoperative respiratory complications.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.